Musculoskeletal and orthopaedic disorders are highly prevalent, disabling and costly. However research on these conditions is hampered by the lack of a robust pipeline of rigorously trained clinical and translational researchers. The COMET (Clinical Orthopedic and Musculoskeletal Education and Training) Program was launched with NIAMS T32 support in 2008 to bolster opportunities for clinical research training in orthopedic and musculoskeletal conditions. The COMET program was highly successful in its first cycle, with five of six program graduates remaining in academic positions and three of six obtaining K-level NIH Career Development Awards. This application proposes a renewal of the COMET T32 program. We have added four new faculty and four new research units to provide increased clinical, musculoskeletal research opportunities in women's health and skeletal health. The objectives of the COMET T32 training grant is to provide pre- and postdoctoral candidates with a rigorous program of training in clinical, translational, epidemiological and policy research involving musculoskeletal and orthopaedic disorders. The program focuses on prevention, recognition, burden and impact of these disorders and operative and nonoperative treatment. The research areas include osteoarthritis, osteoporosis, regional disorders (spine, knee, shoulder, upper extremity, foot/ankle) bone, joint and soft tissue problems, nerve entrapments, chronic pain and related conditions. The program supports training in a range of complementary disciplines including epidemiology, biostatistics, pharmacoepidemiology, decision sciences, economic analysis, health disparities and behavioral interventions. This application requests funding for two predoctoral and three postdoctoral training positions per year. The trainees spend at least two years in the program. Those without prior formal didactic training obtain a master's degree in the Clinical Effectiveness Program at Harvard School of Public Health. The faculty includes outstanding mentors from Harvard Medical School, Harvard School of Public Health, Brigham and Women's Hospital and other Harvard medical institutions. The faculty members conduct research on a wide range of clinical areas and methodological disciplines. In its initial funding period, the COMET T32 program has begun to fulfill the need for clinical research training opportunities in musculoskeletal disorders. This renewal application builds upon the program's early successes and furthers the overarching programmatic goal of facilitating research to improve the quality of life of persons with musculoskeletal disorders.